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weekly_rounds_july_15_2019_wsma_is_growing_and_on_the_moveWeekly Rounds: July 15, 2019 - WSMA Is Growing and on the MoveLatest_NewsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_july_15_2019_wsma_is_growing_and_on_the_move<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>July 15, 2019</h5> <h2>WSMA Is Growing and on the Move</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> <strong>New vistas and another record-breaking membership year</strong> </p> <p> While I spend most of my time focused on representing the physician community in our state, just a couple weeks ago, I was in Spain and saw the Organización Médica Colegial de España. It reminded me that physicians everywhere need representation and a voice. </p> <p> Medical associations around the globe have a strong and lengthy heritage, with forward-thinking physicians seeking to better the profession and build its future. As we stand on the shoulders of those who've gone before, protecting the profession remains our specialty, even if the societies of today look quite different than they did in the past. </p> <p> WSMA's membership is more diverse than ever before in terms of age, gender, specialty, and practice setting. And our strategies, structure, and brand are changing as well, to better reflect who we are today and who we want to be tomorrow. Perhaps you've even noticed that this email has an updated design that ties in with our new logo and branding. </p> <p> Even better, I'm proud to note that the WSMA has had another record-breaking membership year. With membership reaching nearly 11,300 members, we've grown more than 2 percent over last year and achieved a 16 percent increase since 2015. </p> <p> Some of that recent growth is thanks to the investment decisions Washington Permanente Medical Group and Rockwood MultiCare made to fund physician and physician assistant memberships in the WSMA. These organizations join many other groups who value their medical teams and recognize the importance of direct physician involvement in advocacy and leading change. </p> <p> With this growth, our membership is trending younger, as we strive to cultivate a new generation of engaged members. In fact, the early career segment of our membership (students, residents, fellows, and physicians under 40 or in the first 10 years of practice) has grown 214 percent over the past five years. </p> <p> There truly is strength in numbers, which enables the WSMA to have a powerful collective voice when speaking up for what matters to physicians. I'm grateful to all the groups and individuals who invest in WSMA membership. By doing so, you're making a direct investment in professional fulfillment and leadership development that, ultimately, is an investment in quality care and better patient outcomes. </p> <p> At the heart of all of this work is you, our members. As a member-driven organization, it's critical that we hear from you. I'm ever mindful of how busy you are. I know that WSMA news about what we're working on and how that work impacts you, your patients, and your practice may get overlooked. </p> <p> That's why we use every communication channel available to keep you filled in on the good work we're doing on your behalf. We reach out to you in print with our flagship—and newly redesigned—publication, we have several digital channels (website, email, Twitter, Facebook, LinkedIn, webinars, videos) and events (annual meeting, leadership conference and courses, legislative summit, advocacy council, large-group meetings). </p> <p> But in addition to all of that, we are taking WSMA on the road this summer, visiting three cities in Washington state—Spokane, Vancouver, and Bellingham—so that we can meet face to face with our members in those communities. </p> <p> If you're in or near any of those cities, we hope you will join us at these free events scheduled on Thursday evenings from 6-8 p.m. In addition to fun, food, and frosty beverages, we'll offer brief WSMA updates; but, more importantly, we'll listen to you about your concerns in daily life as a medical professional. Your input ensures that we are working on what matters most to you and helps us shape a meaningful strategy for the future. </p> <p> This will be a great chance to meet and mingle with WSMA and your colleagues. Let us know that you plan to join us by registering today to reserve your spot at these free events. The WSMA Road Trip visits Spokane on Thursday, Aug. 22 (<a href="">register online</a>); Vancouver on Thursday, Aug. 29 (<a href="">register online</a>); and Bellingham on Thursday, Sept. 5 (<a href="">register online</a>). We'll see you there! </p> <p> Another way to inform us about issues of concern to you is to engage with us via our members-only virtual reference committees and general discussion forum in advance of the WSMA Annual Meeting. It's easy to post your ideas or comment on the ideas of others. Simply <a href="">click here</a> to get started. </p> <p> All of this to say…as a membership-driven organization your viewpoints and opinions matter, regardless of your specialty, your geography, and/or whether you are working within a large integrated group or small private practice. You matter. Let us hear from you, and I hope to personally greet you in Spokane, Vancouver, or Bellingham this summer. </p> </div>7/15/2019 12:00:00 AM1/1/0001 12:00:00 AM
medical_commission_license_renewal_fee_increase_still_under_considerationPhysician/PA License Renewal Fee Increase Rulemaking Still ActiveLatest_NewsShared_Content/News/Membership_Memo/20190710/medical_commission_license_renewal_fee_increase_still_under_consideration<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Stethoscope-on-table-645x425px.jpg" class="pull-right" /> </div> <h5> July 10, 2019 </h5> <h2>Physician/PA License Renewal Fee Increase Rulemaking Still Active</h2> <p>In May, the WSMA <a href="">called on members to act</a> in response to the Washington Medical Commission's release of proposed rulemaking raising license renewal fees for allopathic physicians (from $657 to $1,012) and physician assistants (from $202 to $396). While the Medical Commission reported then that the public commenting period would close on May 7 and the rule adopted on May 17, the WSMA has confirmed that the fee increase proposal is still an active rule—and commenting is still available. If you continue to have concerns, please share your comments with the Medical Commission at <a href=""></a>. For reference, see WSMA's formal response to the <a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/WMC_Fee_Increase_CR-102_Comment_Letter_May_2019.pdf]" name="proposed CR-102 rule"><a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/WMC_Fee_Increase_CR-102_Comment_Letter_May_2019.pdf]">proposed CR-102 rule</a> </a> that details our concerns regarding the commission's justifications for the fee increases. We will continue to provide updates and share any opportunities for advocacy as the rulemaking proceeds.</p> </div>7/10/2019 12:00:00 AM1/1/0001 12:00:00 AM
registration_now_available_for_the_2019_wsma_annual_meetingRegistration Now Available for the 2019 WSMA Annual MeetingLatest_NewsShared_Content/News/Membership_Memo/20190710/registration_now_available_for_the_2019_wsma_annual_meeting<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Speaker at the WSMA House of Delegates" src="/images/Events/AM_2018.10.042-645x425px.jpg" class="pull-right" /> </div> <h5> July 10, 2019 </h5> <h2>Registration Now Available for the 2019 WSMA Annual Meeting</h2> <p>Connect with your colleagues from around the state for a weekend of policy discussions, educational sessions, and networking opportunities at the 2019 Annual Meeting of the WSMA House of Delegates, scheduled for Oct. 12-13 in Seattle. This year, we're once again welcoming the Washington State Radiological Society, which will hold its business meeting that Saturday afternoon and join with the WSMA to offer educational sessions throughout the day, available to all WSMA and WSRS members in attendance.</p> <p>Key highlights at this year's meeting include:</p> <ul> <li>Keynote presentation: "Healthcare 3.0: How Technology is Driving the Transition to Prosumers, Platforms, and Outsurance" with <strong>Rubin Pillay, MD, PhD</strong> , chief innovation officer of the health system at the University of Alabama School of Medicine in Birmingham.</li> <li>"Physician Leadership and the Urgency of the Moment in Medicine" presented by AMA President <strong>Patrice Harris, MD</strong>.</li> <li>Reception and inauguration of 2019-20 WSMA president, <strong>William Hirota, MD.</strong></li> <li>Breakout educational sessions featuring physician experts on a variety of topics.</li> </ul> <p>Also on the agenda are returning favorites such as our welcome breakfast for first-time attendees and early career physicians, the WAMPAC luncheon (for those passionate about politics), our 2nd annual WSMA Foundation fundraising dinner, and much more.</p> <p>The WSMA Annual Meeting is free for all WSMA and WSRS members. For a full agenda and to register, <a href="">visit the WSMA website</a>. Discounted rooms are available at the Hilton Seattle Airport & Conference Center—reserve your room <a href="">online</a> or by calling 1.800.HILTONS. Sept. 11 is the deadline to receive WSMA's special room rate.</p> </div>7/10/2019 12:00:00 AM1/1/0001 12:00:00 AM
updates_to_apple_health_opioid_prescribing_policyUpdates to Apple Health Opioid Prescribing PolicyLatest_NewsShared_Content/News/Membership_Memo/20190710/updates_to_apple_health_opioid_prescribing_policy<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Physician inspecting prescription medicine bottle" src="/images/News/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" /> </div> <h5> July 10, 2019 </h5> <h2>Updates to Apple Health Opioid Prescribing Policy</h2> <p>The Health Care Authority <a href="">recently announced</a> updates to its Apple Health (Medicaid) opioid clinical policy to align with the <a href="">federal SUPPORT Act passed in 2018</a>. The policy's requirements remain largely the same as when first issued by the HCA in October of last year (and endorsed by the WSMA and the Washington State Hospital Association in return for an <a href="">agreement by the HCA to include expedited prior authorization</a>). Changes include an attestation that chronic pain best practices are being followed when prescribing more than the acute policy limit within a 90-day period, and prior authorization on claims that exceed the 120 morphine milligram equivalent (MME) limit. Visit <a href="">the HCA website</a> to review the changes, effective Oct. 1.</p> </div>7/10/2019 12:00:00 AM1/1/0001 12:00:00 AM
health_at_riskHealth at RiskLatest_NewsShared_Content/News/Latest_News/2019/July/health_at_risk<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/July-Aug-Reports-Article-Graphic-645x425px.jpg" class="pull-right" /></div> <h5>July 2, 2019</h5> <h2>Health at Risk</h2> <p> By Rita Colorito </p> <p> Every spring and summer, Tony Butruille, MD, a family physician in Leavenworth, deals with the impact of what the World Health Organization says is the "greatest public health threat in the 21st century" - climate change. Throughout Washington state, wildfires are the front-and-center concern, with the highest number of fires on record in 2018. </p> <p> Leavenworth, a Bavarian-style city of some 2,000 people in the foothills east of the Cascade Mountains, has the state's greatest exposure to wildfires, according to the U.S. Forest Service Pacific Northwest office. At times last August, the air quality in Washington was the worst in the world, with Seattle experiencing several consecutive days of unhealthy air. </p> <p> August has become a shut-in period for many of Dr. Butruille's patients as they try to avoid the smoke. </p> <p> "Respiratory issues, asthma, COPD, and allergies all spike when you have drier conditions and more smoke and allergens in the air," says Dr. Butruille. "Those exacerbations are not only much more frequent, but can also be much more severe." </p> <h3>The dangers of wildfire smoke</h3> <p> According to the 4th National Climate Assessment, rising temperatures worldwide, driven by skyrocketing greenhouse gases, have led to a cascade of increasingly frequent and severe heat events, drought, and flooding, as well as sea level rise and spread of disease-carrying insects that impact the environmental and societal determinants of public health—clean air and water, sufficient food, and safe shelter. </p> <p> Washington's Department of Natural Resources predicts 2019 will experience hotter, drier temperatures and an earlier and longer fire season— and it's not just the drier eastern half of the state. Some 40 percent of last year's 1,850 fires, and 49 of 50 unseasonal wildfires that occurred by the end of March, struck west of the Cascades. </p> <p> Wildfire smoke poses the greatest risk to young children, pregnant women, the elderly, and those with asthma, allergies, and heart and lung problems. </p> <p> "The more smoke and air pollution we have in our environment, the more cardiovascular, cerebrovascular, and pulmonary diseases we can expect to see," says Jeffrey Duchin, MD, a physician and health officer for Public Health – Seattle & King County. </p> <p> Also impacted are those with kidney problems, says Annemarie Dooley, MD, a nephrologist in Bellevue. </p> <p> "Your kidneys act as a giant sieve," says Dr. Dooley. "Small particulate matter, under 2.5 micrometers, penetrates very deeply into lung tissue, is absorbed through the bloodstream, circulates to the heart, and the kidneys get 20 percent of what's filtered through the heart every second." </p> <p> Researchers are still determining other developmental and long-term effects of wildfire smoke on children, who breathe more air per pound of body weight than adults because their metabolism runs faster, says Chris Covert-Bowlds, MD, a family physician in Seattle. </p> <p> "The concern is that their lung development may never reach its full potential," he says. </p> <h3>The cascading effects of heat</h3> <p> Climate change means another new normal for Washington—increased temperatures and extreme heat events. A report from the University of Washington Climate Impacts Group (CIG) finds climate change is likely to increase heat-related illness, including heat exhaustion and stroke. Nationwide, extreme heat kills more Americans than any other form of severe weather. </p> <p> Between 1990 and 2010, King County saw a 10 percent increase in deaths on "extreme heat days," according to the National Climate Assessment. Recent heat waves have seen a significant increase in hospitalizations, especially for the elderly, says Dr. Duchin. </p> <p> Increased temperatures play a major role in ground-level ozone and fine particulate matter (PM2.5), both widespread air pollutants in Washington that increase the risk of cardiovascular disease and death, including death from lung cancer. With high concentrations of these pollutants, Yakima and the greater Spokane area received failing grades from the American Lung Association's most recent air quality report. </p> <p> Renal health also should be on everyone's radar, says Dr. Dooley. Heat stress can impact those with existing renal injury or at an increased renal risk, such as those with diabetes, as well as people whose kidneys are otherwise healthy. "You can form kidney stones just by being dehydrated without having any kidney injury, by working or even playing out in hot weather," she says. </p> <p> Carbon dioxide in the atmosphere not only makes the trees produce more pollen, but the warmer weather and reduced rainfall is causing the pollen season to start earlier, last longer, and become more severe. "People are having asthma symptoms earlier and worse than ever before," says Dr. Covert- Bowlds, whose son has asthma. </p> <p> The result is also more severe allergy flares, says Markus Boos, MD, a pediatric dermatologist with Seattle Children's. "We have clinics where it's wall-to-wall kids with atopic dermatitis," he says. </p> <h3>Vector-borne and infectious diseases</h3> <p> Warmer year-round temperatures worldwide are also driving the population of disease-carrying mosquitoes and ticks. In the United States, vector-borne disease cases tripled from 2004 to 2016, according to the Centers for Disease Control and Prevention. Washington state is home to more than 40 species of mosquitoes, many of them capable of spreading disease. </p> <p> Higher temperatures have led to an earlier onset of the potentially fatal West Nile virus-carrying mosquitoes, according to the Washington State Department of Health's vector surveillance program. Since the first three human cases of West Nile reported in Washington in 2006, there have been an additional 92 endemic cases. King County had its first reported case of West Nile last summer. </p> <p> The few reported cases of Zika virus were acquired elsewhere. The fear nationwide is that it's only a matter of time before the two types of mosquitoes that cause Zika move northward. </p> <p> Warming sea temperatures and increasing ocean acidity fuel harmful algal blooms that can contaminate recreational water and shellfish. Warming waters are also becoming more hospitable to disease-causing pathogens such as vibrio, says Dr. Duchin. "Vibrio cases have risen dramatically in recent years; it's a disease that grows where a lot of our shellfish are farmed," he said. "People get nasty gastroenteritis— vomiting, diarrhea—from vibrio. And it also has a real economic impact." </p> <h3>Vulnerable communities</h3> <p> Communities of color, those with lower incomes, and indigenous people face the greatest and disproportionate climate risks, a CIG study found. These marginalized communities often lack the resources needed to manage their health or get the medical help they need, says Heidi Roop, a CIG climate change and equity researcher. </p> <p> In Washington's agricultural sector, some 79 percent of outdoor farm workers experience a heat-related illness during summertime harvest. Those workers are vulnerable to heat-stress nephropathy, says Dr. Dooley. It's the leading killer of men under age 45 in Central America, where the majority of the population works outdoors. </p> <p> Exacerbating the health of many outdoor workers during periods of high heat or wildfire smoke is that they often don't seek medical help for fear of losing their job, says Russell Maier, MD, a family physician in Yakima, and physician advisor to the dean of Pacific Northwest University of Health Sciences. "If they do come in, what we're seeing is more advanced respiratory illness. It's hitting them when they can least afford it." </p> <p> In Seattle, and other highly populated cities, the air quality is always worse in lower-income communities, which often sit near major highways, says Dr. Covert- Bowlds. These communities often lack air conditioning necessary to deal with heat waves or times of wildfire smoke. </p> <p> "Polar bears dying is sad, but kids in South Seattle struggling to breathe is the current face of climate change and air pollution," he says. "That human suffering is what drives us to keep at it." </p> <p> Smoke and air quality aren't the only climate change-related health concerns, says Roop. "If people live in flood plains and in coastal areas with sea level rise, those all have impacts on people's health and their ability to live in a clean home absent mold and contaminated drinking water," she says. </p> <p> The impact of climate change goes beyond the physical. Mental health issues are often not discussed, but are a significant burden of climate change, says Dr. Duchin. "Extreme weather events, like heat waves and floods and windstorms all have significant mental health effects, particularly post- traumatic stress disorder, anxiety, and depression." </p> <h3>Physicians must speak out</h3> <p> Physicians are in a unique position to advance the dialogue on climate change, but public health systems face a steep hurdle when it comes to addressing climate change. </p> <p> "We don't have the resources in place to adequately track the health consequences of climate change," says Dr. Duchin. "It lends to this complacency and helps people to minimize the fact that this is the single largest health threat facing us and will be for centuries unless we get our act together quickly." </p> <p> "Sometimes doctors get too focused on treating the disease without asking, 'What are people going to do to solve the causes?'" Dr. Dooley says. "We should be screaming red [alert] in the summer to get vehicles off the road. The problem is not only particulate matter from wildfire smoke, but from diesel emissions." </p> <p> Every physician has a responsibility to get involved, Dr. Butruille says. "We are seeing the public health effects of climate change now," he says. "We're going to see more of them in the future and shame on us if we don't do what we can to both prepare for and mitigate the results." </p> <p> <em>Rita Colorito is a freelance journalist who specializes in writing about health care.</em> </p> <p> <em>This article was featured in the July/August 2019 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="">purchase a subscription</a>.</em> </p> </div>7/2/2019 12:00:00 AM1/1/0001 12:00:00 AM
taking_a_standTaking a StandLatest_NewsShared_Content/News/Latest_News/2019/July/taking_a_stand<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/July-Aug-Reports-Article-Graphic-645x425px.jpg" class="pull-right" /></div> <h5>July 2, 2019</h5> <h2>Taking a Stand</h2> <p> </p> <p> By Pat Curry </p> <p> Several Washington state hospital systems have been recognized for their efforts to reduce their effect on climate change. WSMA Reports talked to the sustainability managers at three health care organizations about the steps they have taken and asked them to suggest small steps individual physicians can take. </p> <h3>Virginia Mason Medical Center</h3> <p> Since 2011, Virginia Mason's energy conservation efforts have saved more than 4.5 million kilowatt hours per year, and water conservation efforts have saved around 7 million gallons of water annually. The hospital's food and nutrition department purchases nearly 40 percent locally or sustainably, and the hospital's recycling and composting efforts achieved a 48 percent rate. </p> <p> "Our footprint is giant as an industry," says John Leigh, director of sustainability for Virginia Mason. "We are in the business of human well-being. Knowing climate change will have negative effects on the health of human beings, it would be unconscionable to not doing something about it as soon as possible." </p> <p> An ad hoc green team at Virginia Mason focuses on recycling, looking at ways to improve signage and locate recycling bins. Every effort is important because hospitals generate so much waste through single-use or disposable items for infection control. </p> <p> "Patient safety will always trump waste generation," he says. "It always will—and it should." </p> <p> The health care industry is responsible for 10 percent of the nation's total emissions in greenhouse gases, including the use of anesthetic gases. One of the biggest impacts of the efforts at Virginia Mason is a radical reduction in the use of desflurane. The available options are more sustainable and less expensive. </p> <p> "One doctor got behind this work here with my predecessor," Leigh says. "It just takes one champion to start asking questions in their department and pushing those who are reluctant to give it a try and see it can be done. ... That was one thing we could do without a lot of difficulty or fanfare." </p> <p> Leigh says his "grand plan" is for Virginia Mason to achieve carbon neutrality, which means taking action to remove as much carbon dioxide from the atmosphere as you put into it. That means spending money on upgrading equipment. Justifying the expense can be tough at a health care facility, he says. </p> <p> "This is an industry with not a lot of surplus capital to perform important facility upgrades like this," he says. "We tend to lose out on internal competition for capital improvements. It's hard to compete against an MRI or another important piece of equipment." </p> <p> A quick win for individual physicians is to "green up" the supplies; use less in the first place wherever possible, and then challenge manufacturers and suppliers to find ways to move toward environmentally preferable products and packaging. </p> <p> They can also look at whether any items in their clinics expire before they are used. </p> <p> "Focusing on reducing waste can have a lot of environmental benefit," he says. "Reducing 5 percent is pretty doable from my observation." </p> <h3>MultiCare Health Systems</h3> <p> MultiCare has been focused on sustainability for at least a decade, and is the parent company to Washington state's first green hospital, Good Samaritan Hospital Dally Tower in Puyallup. The system recently hired Tony Garcia, who ran the sustainability program at the Disneyland Resort for 10 years. </p> <p> His early efforts are focusing on establishing task forces looking at technology, waste management, and water conservation. A sustainability committee of senior leaders steers the direction of the program. </p> <p> The big wins in sustainability occur when senior executives see saving energy, water, and solid waste as a revenue stream, Garcia says. </p> <p> "If you save costs on utilities, it's the same as generating revenue," he explained. "Cost cutting is nothing new in health care; this is a painless way to cut costs because you're not affecting your service level, you're reducing what you spend on a utility." </p> <p> The easiest way to reduce energy and water consumption, he says, is through technology and automation. </p> <p> "Sometimes the hardest part is getting authorization to invest in technologies, but there is a lot of proven technology out there we can leverage," he says. </p> <p> For example, sensors help reduce energy use because they "don't require someone to turn something on or off, so there's no training required," Garcia says. Software ensures air handlers work efficiently, filters are clean, and the system is sequenced accurately and calibrated for the use of each space. </p> <p> Small changes can add up as well. LED lights use less energy, require far less maintenance, and provide better light quality than incandescent or fluorescent bulbs. Ultra-low-flow toilets reduce the water usage rate per fixture; if automatic flush vales are used, careful calibration could reduce the amount of false flushes. </p> <p> One area that can make a big difference is space management, says Ron Fues, project director with construction engineering firm McKinstry, which works with MultiCare. </p> <p> "Your space changes all the time; an office could have once been a storage room or a waiting room," he says. "What often gets overlooked is the HVAC system that supports that space. ... In some cases, spaces need to be adjusted for more or less air flow." </p> <p> If physicians lease a building, they should "be the squeaky wheel," Fues says. "If you see that things are automatically on at weird hours, put in a work order. That's an easy fix. If you own your own building, the EPA has a utility bill benchmarking tool (<a href=""></a>). You should be benchmarking your building to see how your building compares on a per square foot basis versus other similar buildings." </p> <h3>Seattle Children's Hospital</h3> <p> A 2019 winner of the Practice Greenhealth Environmental Excellence Award, Seattle Children's Hospital set several environmental goals in 2017 and achieved them within a year. Water use for irrigation was reduced by about a million gallons. </p> <p> The hospital also increased a daily pay incentive to $4.50 to employees to carpool, bike, walk, or take public transit. Staff members who carpool or vanpool can park on campus. A shuttle is provided from the Link light rail station to the hospital. </p> <p> "Asthma is always in our top 5 in admissions," says Colleen Groll, manager of Seattle Children's sustainability program. "When we get more staff out of their cars, we're reducing pollution because in Seattle, transportation is the Number 1 emission." </p> <p> Pulmonologist Jonathan Cogen, MD, noted that many of his patients drive long distances to see him. He could help with that. </p> <p> "[One] morning, four of my five patients came over from Yakima for a half-hour visit," he says. "If I went out there, it would have cut those drives." </p> <p> Reducing waste reduces carbon emissions, so dermatologist Markus Boos, MD, changed the way he has his staff set up his trays for skin biopsies. "The nurses are great and they would set up these beautiful trays," he says. "I would use half of it and the rest was thrown away. I had them put on the bare minimum and then hand me whatever else is needed." </p> <p> Physicians can help the environment and save money for their practices by properly disposing of medical waste. </p> <p> "Some people think a piece of gauze with a little blood on it needs to go in the red waste bag," he says. "Those bags are actually for things that are soaked with waste that can be expressed. Those items are a lot more involved to dispose of." </p> <p> Whether physicians have their own prac- tices or work in a group or a hospital system, they can make a difference by speaking up. </p> <p> "Sometimes, as physicians, we are afraid of talking about controversial issues," he says. "There's nothing controversial about this; the world is getting warmer. We should care about the children in front of us. That is a way to talk about it without getting on our high horse or use terms that are off putting. When I hear about climate change, it can feel overwhelming. What can I do as one person? As a society, everybody's voice matters." </p> <p> <em>Pat Curry is WSMA Reports' senior editor.</em> </p> <p> <em>This article was featured in the July/August 2019 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="">purchase a subscription</a>.</em> </p> </div>7/2/2019 12:00:00 AM1/1/0001 12:00:00 AM
ama_welcomes_first_female_african_american_president_other_news_from_ama_annual_meetingAMA Welcomes First Female African American President; Other News from AMA Annual MeetingLatest_NewsShared_Content/News/Membership_Memo/20190626/ama_welcomes_first_female_african_american_president_other_news_from_ama_annual_meeting<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/HeadShots/Patrice-Harris-MD-Circle-645x425px.png" class="pull-right" /> </div> <h5> June 26, 2019 </h5> <h2>AMA Welcomes First Female African American President; Other News from AMA Annual Meeting</h2> <p>Patrice Harris, MD, was sworn in as the American Medical Association's 174th president at the AMA's annual House of Delegates meeting in Chicago earlier this month. Dr. Harris is the first African American woman to hold the office and only the fifth female president in the organization's history.</p> <p>Watch the live broadcast of Dr. Harris' historic inauguration <a href="">here</a> (her swearing in and inaugural address begin at timestamp 48:45) and read <a href="">a Q&A with the new AMA president</a> to learn more about her goals for the AMA in the coming year.</p> <p>In other news from the meeting, AMA delegates narrowly voted to continue its opposition to a single-payer health system, adopting new policy instead to push for universal coverage by supporting improvements to the Affordable Care Act, including:</p> <ul> <li>Eliminating the subsidy "cliff," thereby expanding eligibility for premium tax credits beyond 400 percent of the federal poverty level.</li> <li>Increasing the generosity of premium tax credits.</li> <li>Expanding eligibility of cost-sharing reductions.</li> </ul> <p>See <a href="">this AMA report</a> for more highlights from the meeting. As they do every year, the WSMA's AMA delegation, comprised of four WSMA members representing the interests of Washington physicians and patients, brought forward several issues during the meeting, including:</p> <ul> <li>The concept of offering state employee health plans to every state resident and making the federal employee health benefits program health insurance plans available to everyone (referred for further study).</li> <li>Alignment of federal privacy law and regulations with HIPAA for the purposes of treatment, payment, and health operations, while ensuring protections are in place against the use of "Part 2" substance use disorder records in criminal proceedings (amended to reference applicable state laws).</li> <li>Universal access for essential public health services (alternative language adopted).</li> <li>An AMA study and report on the conditions under which our country could successfully eliminate the manufacture, distribution, and sale of combustible cigarettes and other combustible tobacco products (referred for decision).</li> </ul> </div>6/26/2019 12:00:00 AM1/1/0001 12:00:00 AM
mmr_exemption_update_updated_form_and_new_webinarMMR Exemption Update: Updated Form and New WebinarLatest_NewsShared_Content/News/Membership_Memo/20190626/mmr_exemption_update_updated_form_and_new_webinar<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/2019-HB-1638-Signing-645x425px.jpg" class="pull-right" /> </div> <h5> June 26, 2019 </h5> <h2>MMR Exemption Update: Updated Form and New Webinar</h2> <p><a href="">House Bill 1638</a>, WSMA-backed legislation eliminating the personal and philosophical exemption for the measles, mumps, and rubella (MMR) vaccine, takes effect July 28. Make sure you're prepared with the following new resources.</p> <p>The Department of Health recently released an updated certificate of exemption form for school, childcare, and preschool immunization requirements. Download the new form from the Department of Health's <a href="">Immunizations Forms page</a>.</p> <p>Important: Several WSMA members have contacted us regarding the new certificate of exemption form. With the elimination of the personal and philosophical exemption for the MMR vaccine, you may notice an uptick in the number of parents claiming a religious exemption to the vaccine. For the form to be valid, a physician or other authorized provider must sign the document attesting they have "…discussed the benefits and risks of immunizations with the parent/legal guardian as a condition for exempting their child." By signing the form, you are indicating that you have discussed the benefits and risks of immunizations. You are not affirming the validity of their religious beliefs.</p> <p>According to the Department of Health, there is nothing in state statute that requires a physician to sign the form. However, a physician may open themselves up to discrimination claims if they attempt to evaluate the validity of a patient's religion or religious claims prior to signing the form. While the risk for litigation may be lower, this warning extends to physicians who refuse to sign any religious exemptions at all. The WSMA recommends consulting with legal counsel before making any decisions about whether or not to sign these exemption forms.</p> <p>If you have additional questions about the exemption policy and the new immunization law, the Department of Health and Washington Chapter of the American Academy of Pediatricians are hosting a joint webinar this Friday, June 28 from 7-8 a.m. <a href="">Pre-register for the free webinar here</a>. If you are unable to attend the webinar, you can send follow-up questions to Billie Dickinson, WSMA policy analyst, at <a href=""></a>.</p> <p><em>Photo: WSMA member Alan Melnick, MD, right, with Gov. Inslee as he signs House Bill 1638, removing the personal/philosophical exemption for the MMR vaccine.</em></p> </div>6/26/2019 12:00:00 AM1/1/0001 12:00:00 AM
wsma_is_hitting_the_roadWSMA is Hitting the Road!Latest_NewsShared_Content/News/Membership_Memo/20190626/wsma_is_hitting_the_road<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Events/WSMA-Road-Trip-Graphic-645x425px%20(1).jpg" class="pull-right" /> </div> <h5> June 26, 2019 </h5> <h2>WSMA is Hitting the Road!</h2> <p>WSMA leaders are hitting the road this summer to connect with you in person and hear from you directly about what's impacting you in the practice of medicine. Everyone is welcome to join us for these free events, which will feature food and beverages, an update from legislative session, a Q&A with WSMA leadership, networking with peers, and more! Don't miss this meet-up with the WSMA. Registration details to come—for now, save the date: The WSMA Road Trip will visit Spokane on Thursday, Aug. 22; Vancouver, Thursday, Aug. 29; and Bellingham, Thursday, Sept. 5.</p> </div>6/26/2019 12:00:00 AM1/1/0001 12:00:00 AM
ai_and_the_next_generation_of_physiciansAI and the Next Generation of PhysiciansLatest_NewsShared_Content/News/Latest_News/2019/June/ai_and_the_next_generation_of_physicians<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/WSMA_MayJune-Reports-Cover-Article-Image-645x425px.jpg" class="pull-right" /></div> <h5>June 21, 2019</h5> <h2>AI and the Next Generation of Physicians</h2> <p> By Pat Curry</p> <p>Seventeen thousand genes.</p> <p> Five driver events of cancer progression: gene expression, mutations, copy number, methylation, and known regulators of gene expression. </p> <p> Fifty-three chemotherapeutic drugs that are FDA-approved and reasonably effective. Every tumor is different. Which drug will work best to fight each one? </p> <p> "Our gut said the gene expression was affecting the drug sensitivity resistance...if we could figure out what those genes were," says Pamela Becker, MD, PhD, professor of medicine in the UW School of Medicine Division of Hematology and a member in the Clinical Research Division of the Fred Hutchinson Cancer Research Center. </p> <p> But there were just too many variables to consider to achieve any degree of accuracy. </p> <p> "To correlate 17,000 things with 50 things doesn't work," Dr. Becker says. "We needed another method; machine learning, also known as AI, is the method that can do that." </p> <p> Dr. Becker is part of a research team at the University of Washington that is applying a combination of machine learning and big data to improve outcomes for cancer patients. The team—from UW Medicine, the Paul G. Allen School of Computer Science and Engineering, and the UW Department of Genome Sciences—developed MERGE, a new algorithm integrating five criteria impacting genes' contribution to cancer development. Using MERGE (short for "Mutation, Expression hubs, known Regulators, Genomic CNV, and mEthylation"), the team narrowed down the group of genes that would be sensitive or resistant to chemotherapeutic drugs from 17,000 to about three dozen. </p> <p> "The higher or lower expression of those genes seems to be related to sensitivity of the entire class of agents," Dr. Becker says. "It reassured us we were on the right track. This was a huge first step to find the genes that seem to be related to drug sensitivity or resistance. That would help us figure out the best drugs for each patient." </p> <p> The MERGE project is just one example of the ways Washington state's medical schools are using AI to advance health care for the next generation of physicians. This type of research is happening in every area of medicine, Dr. Becker says. Patient genetic profiles will be readily available to help customize treatment. </p> <p> "Therapeutic information, drug dosing, this will get more and more sophisticated," she says. "For [medical] students, it's important to know that this is happening. Our tools will be better, more defined, and more able to recognize all these differences between people." </p> <h3>A tool for bringing specialties to rural areas</h3> <p> Robert Sorrells, PhD, associate dean for pre-clinical education and associate professor of anatomy at Pacific Northwest University of Health Sciences, was a cognitive science specialist for the University of Georgia's Artificial Intelligence Group before joining the faculty at PNWU. With a research focus on neural and computer modeling of knowledge representation and learning, Dr. Sorrells has written on artificial intelligence and the future of health care. </p> <p> For PNWU, whose mission is to increase access to health care in rural areas, AI offers some intriguing possibilities for reaching rural areas that are underserved by specialties such as radiology and pathology. </p> <p> "AI isn't going to replace those specialties," Sorrells says. "They aren't there in those rural areas. AI can be an interface between the physician and patient to deliver health care. When we can't get into rural areas, we can train the students to use the interface. Those are huge initiatives we want to equip our students for. With electronic medical records, algorithms can see patterns the primary care physician doesn't have the time or the bandwidth to put together. We want to train our students to use them before they're even available to the nascent population." </p> <p> Today's medical students, who were born in the digital age and are extremely comfortable with technology, seem open and accepting of the new tools they will have at their disposal. Electronic stethoscopes can find a heart murmur that can't be heard by the human ear and provide a preliminary diagnosis. </p> <p> Ultrasounds that connect to smartphones or tablets will be the "next huge thing in primary care," he says. "You can get this information without having to send a patient off to the city," he says. "When these tools hit the market, our students will already know how to use them." </p> <p> Will AI change the coursework at medical school? Somewhat, Dr. Sorrells says, but only to the extent that it changes the tools. </p> <p> "We still teach science," he says. "A doctor needs to be able to think through her science. When there isn't an iPhone or a stethoscope available, what kind of data do I need? We won't ever replace having very knowledgeable doctors who can reason through what can't be dealt with algorithmically." </p> <p> One role of medical schools, he says, is to help address not only the technical advances provided by AI, but the ethical and cultural ones that physicians face every day. </p> <p> "We need to train AI about cultural distinctions and teach them to respect and embrace those differences," he says. </p> <h3>An incubator for innovation</h3> <p>The state's newest medical school, Washington State University's Elson S. Floyd College of Medicine, has taken the approach of creating a technology incubator, which is in the planning stages. The goal of the incubator will be to develop tools, technology, processes, and innovations to address health care problems in rural and underserved care and population health. It stands to reason that many of these initiatives will involve some aspect of AI. </p> <p> The medical school also does a "wonderful job of providing an environment for students and faculty to explore applications of emergent technology in all aspects of medicine," says Chris Martin, director of the medical school's simulation-based training. </p> <p> Martin, whose department focuses on the use of virtual reality for medical training, notes that many of the devices his students use—Bluetooth-enabled blood pressure cuffs and glucometers, for example— download the results to a computer. </p> <p> "We are finding is we have plenty of data," he says. "The vast amounts of data are difficult for a single person or a team to synthesize to understand what's going on with a patient or a disease process." </p> <p> That, he says, is where AI can be extremely helpful. </p> <p> "It won't replace the role of a physician, but will be able to augment their practice to provide better outcomes," he says. "It's just another example of how technology can better a practice rather than alter the trajectory of a profession. AI is great, but it still needs a teacher." </p> <p> <em>This article was featured in the May/June 2019 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="">purchase a subscription</a>.</em> </p> <p> <em>Pat Curry is WSMA Reports' senior editor.</em> </p> </div>6/21/2019 12:00:00 AM1/1/0001 12:00:00 AM
algorithms_as_partners_not_practitionersAlgorithms as Partners, Not PractitionersLatest_NewsShared_Content/News/Latest_News/2019/June/algorithms_as_partners_not_practitioners<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/WSMA_MayJune-Reports-Cover-Article-Image-645x425px.jpg" class="pull-right" /></div> <h5>June 21, 2019</h5> <h2>Algorithms as Partners, Not Practitioners</h2> <p><em>Members only, sign-in required</em></p> <p> By John Gallagher </p> <p> Physicians can't escape the buzz around artificial intelligence in medicine, or the concerns that it raises: visions of robots in white coats practicing medicine by algorithm. If that's not bad enough, many suspect that AI might actually add to their workload instead of relieving it. </p> <p> It's true that AI has the potential to change the way physicians practice. But that change can be for the better. </p> <p> </p> <p> Properly done, AI could help with differential diagnoses, pick up on patterns that might otherwise escape detection, and identify roadblocks to better care. In fact, it is already doing these very things. To expand this achievement even further, the emphasis needs to be on how humans and computers can work together to do better than either can do alone. </p> <p> "You have to realize that it's a tool, just as a stethoscope is a tool," says Michael Anderson, MD, chief medical officer at CHI Franciscan and a WSMA member. "There will never be a substitute for hands-on care of patients." </p> <p> AI might be able to identify patterns in data to provide decision support for clinicians, says Lara Mangravite, president of Sage Bionetworks, a Seattle-based nonprofit focused on open practices for large-scale collaborative biomedical research. That would provide clinicians with more time to focus on "the human part of the job." </p> <h3>Harnessing big data</h3> <p> Measured by dollars alone, AI is a force to be reckoned with in health care. According to a December 2018 report from ReportLinker, investment in health care AI is expected to grow at an astonishing compounded growth rate of 50 percent between now and 2025, reaching more than $36 billion. </p> <p> As with any emerging technology, AI has been the subject of sweeping rhetoric about its potential, both as a disruptor and a panacea. "Data science is really cool and a really hot topic," says Sean Mooney, PhD, chief research information officer of UW Medicine. "It is transforming fields." </p> <p> Mooney acknowledges that as a phrase, AI is subject to shifting meanings. "Isn't it funny how the big- picture words are the hardest to define?" he notes. "I think of AI as learning something from data and using that to inform things." [For a glossary of terms, see facing page.] </p> <p> Indeed, AI can help sort through reams of data to discover information that might otherwise be overlooked. WSMA President Thomas Schaaf, MD, a geriatrician and hospice care physician, says that to him, the value of AI-type systems is the ability to see patterns that could potentially be missed by a human being in analyzing large data sets. </p> <p> "It also brings the ability to suggest alternative diagnosis and treatments based on sufficient data about the patient and their case," he says. </p> <p> Medicine offers no shortage of data from which to draw. But what AI relies upon is good data. That may be rarer than many think. </p> <p> "We like to say, we have EHRs, we have big data, end of story," says David Haynor, MD, a neuroradiologist at UW Medicine, "but it's nowhere near that simple." </p> <p> Indeed, getting data that is reliable and comparable is a challenge uniquely suited to the capabilities of AI systems. Haynor notes that a doctor may treat 1,000 patients for sore throat. "By the time he narrows it down, he's only got 152 patients with a reasonable amount of data: one lab test, a physical exam, and a follow up," he says. "That's not big data. That's tiny data." </p> <p> Creating an algorithm for AI isn't necessarily difficult. Mooney recalls a colleague at Notre Dame who designed a predictive analysis on anonymized claims data using the kind of algorithm Netflix employs to suggest movies you might like. </p> <p> Getting algorithms to be specific and sensitive is another matter. The patterns an algorithm picks out may be legitimate, but not important. Schaaf notes that one analysis determined that "the most reliable marker for a skin cancer lesion is the presence of a ruler next to the lesion." </p> <p> That's why data scientists consider the input of physicians pivotal in creating AI that truly advances patient care. </p> <p> "Data scientists may be using AI to solve problems that clinicians don't need solved; that's a problem that I think might become a real issue," Mangrative says. "Just because clinicians don't know how to manage a 50-terabyte file doesn't mean they aren't exquisitely talented about those things they do know about. We need to take both sets of expertise into account as we design systems." </p> <h3>Teaching AI to learn</h3> <p> Not surprisingly, imaging is a field ripe for AI, and radiology is one specialty where AI has already made significant inroads. Routine imaging, such as mammograms, creates a treasure trove of data that lends itself to computer analysis. </p> <p> A recent study of the performance of AI algorithms in interpreting mammogram results showed that AI is fulfilling its promise—to a degree. "The results were as good or better as the average radiologist's," Haynor says, "but not as good as the best radiologist's." </p> <p> However, algorithms can learn, just as people do. As algorithms have more data to work with, they can become more adept at flagging what truly matters with ever greater accuracy. This machine learning, as it is called, is key to advancing AI and creating systems that provide physicians with information they need to make decisions. </p> <p> For example, Haynor cites the recommended chest CTs that smokers should get every few years. AI could correlate certain features, such as the size of a nodule, with past scans and determine if it warrants the radiologist's further attention. </p> <p> "The ideal model would be something that functions as a radiologist's assistant," he says, "a tireless guy who looks at every study, working in the middle of the night and on Sundays, telling you, 'Look at this particular slice and tell me if that is of concern." </p> <h3>Involving physicians in the process</h3> <p> Even primary care is beginning to feel the impact of AI. Providence St. Joseph Health has created an AI-powered chatbot called Grace to make sure patients can navigate more smoothly through the system. Sunitra Mishra, MD, chief executive of the Express Care program at Providence, says her clinical team worked closely with the tech team to create the logic to determine when patients should be seen at one venue versus another. </p> <p> As a primary care provider, Dr. Mishra says she can see the opportunities AI offers. It could potentially reduce some of the administrative burdens for physicians, giving them more time for patient care and reducing the risk of burnout. </p> <p> Of course, to do so, AI needs to be integrated into the workflow in such a way that it does not make more work. "I'm like all doctors," Dr. Haynor says. "If it takes me more time, and it doesn't make my work easier, why should I do it?" </p> <p> In addition, AI will have to earn the confidence of physicians through rigorous study of how it performs. "It's really important to invest in research around the performance of data science methods in practice and whether they achieve the outcomes we want them to achieve," Mooney says. If AI is able to fulfill all of these goals, it will prove extraordinarily useful in the practice of medicine. </p> <p> What it won't do is supersede the physician-patient relationship. </p> <p> "Whether a patient improves or not depends on whether patients trust their physician and feel listened to," says WSMA member Jessica Schlicher, MD, MBA, medical director for care transformation for CHI Franciscan. "Caring for our people with compassion, coupling the experience with clinical expertise—that's where the power of the physician is. I don't ever see a world where AI can replace that." </p> <p> <em>This article was featured in the May/June 2019 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="">purchase a subscription</a>.</em> </p> <p> <em>John Gallagher is a Washington-based freelance writer who specializes in covering health care and health care policy topics.</em> </p> </div>6/21/2019 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_june_17_2019_hard_won_change_is_worth_the_effortWeekly Rounds: June 17, 2019 - Hard-won Change Is Worth the EffortLatest_NewsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_june_17_2019_hard_won_change_is_worth_the_effort<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>June 17, 2019</h5> <h2>Hard-won Change Is Worth the Effort</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Last week, I was in Chicago attending the AMA annual meeting. After all these years it's still a thrill to witness the incoming president's swearing in, but this year's oath of office felt like the most momentous one ever. In fact, it was an historic moment as the organization's first female African-American president put her hand on Bibles belonging to her great-grandfather and aunt and repeated the time-honored words of the oath. </p> <p> As Patrice Harris, MD, stepped up to that podium (<a href="">view it here</a> at timestamp 48:45), she did so as only the fifth female president in the organization's 174 years. Notably, as she gave her presidential address, she did so 100 years after the first female physician was seated in the AMA House of Delegates. Also? Dr. Harris was preceded by another female president, Dr. Barbara McAneny, and she will be followed by Dr. Susan Bailey, who was elected AMA president-elect. </p> <p> Seeing these brilliant women leading in medicine today was a powerful reminder to me that change takes time—sometimes longer than we wish, but progress comes nonetheless. And as the AMA House of Delegates debated numerous issues—including health system reform, hospital consolidation, and gender inequity in medicine—we saw that democratic progress in action. </p> <p> The House narrowly voted to continue its opposition to a single-payer health system, adopting new policy instead to push for universal coverage by supporting improvements to the Affordable Care Act, including: </p> <ul> <li>Eliminating the subsidy "cliff," thereby expanding eligibility for premium tax credits beyond 40 percent of the federal poverty level.</li> <li>Increasing the generosity of premium tax credits.</li> <li>Expanding eligibility of cost-sharing reductions.</li> </ul> <p> Of particular interest to Washington state (in light of the WSMA's recent work to eliminate the personal and philosophical exemption to the MMR vaccine), the House passed a resolution to support state policies that would allow minors to override their parents' objections to vaccinations. In a separate resolution, the delegates directed the AMA to develop model legislation for mature minor consent to vaccinations. </p> <p> Your WSMA delegates took several issues to the AMA including: </p> <ul> <li>The concept of offering state employee health plans to every state resident and making the federal employee health benefits program health insurance plans available to everyone (referred for further study).</li> <li>Alignment of federal privacy law and regulations with HIPAA for the purposes of treatment, payment, and health operations, while ensuring protections are in place against the use of "Part 2" substance use disorder records in criminal proceedings (amended to reference applicable state laws).</li> <li>Universal access for essential public health services (alternative language adopted).</li> <li>An AMA study and report on the conditions under which our country could successfully eliminate the manufacture, distribution, and sale of combustible cigarettes and other combustible tobacco products (referred for decision).</li> </ul> <p> Here's a shout-out and special thanks to WSMA delegates and alternates to the AMA, for their passion and concern for the future of the profession. The delegation includes: </p> <ul> <li>Rod Trytko, MD, MBA, MPH, chair of the delegation</li> <li>Matthew Grierson, MD, vice chair</li> <li>Peter Dunbar, MD</li> <li>Nariman Heshmati, MD</li> <li>Erin Harnish, MD</li> <li>Shane Macaulay, MD</li> <li>Beth Peterson, MD</li> <li>Sheila Rege, MD</li> </ul> <p> Policy-making matters not only to the profession, but to patients. And as Dr. Harris noted in her keynote address, "There is strength in our collective voice." I couldn't agree more. If you're interested in proposing policy or serving as a delegate at the 2019 Annual Meeting of the WSMA House of Delegates meeting (Oct. 12-13 at the Hilton Seattle Airport & Conference Center), here's some helpful information you'll need to know. </p> <p> Resolutions, one of the key policy drivers for the association, are considered by the House of Delegates at their annual meeting each fall. Learn more about <a href="">how to write a resolution</a> and take note of these dates: </p> <ul> <li>Aug. 16: Deadline to submit your resolution for publication in the delegate handbook, the compilation of resolutions and other business to be considered by the House of Delegates. </li> <li>Aug. 30: Delegate handbook will be available for download from the WSMA website. </li> <li>Sept. 13: Final deadline to submit resolutions. To be considered, resolutions received after this date require consent of two-thirds of the House at the opening session.</li> </ul> <p> You can also circulate your ideas and engage in conversation before the meeting by posting your thoughts on WSMA's password-protected, members-only <a href="">online discussion forum</a>. </p> <p> The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county or state specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2019 WSMA Annual Meeting, contact your local county or state specialty society. </p> <p> Getting involved at this level means bringing influence and insight to the policy-making process of your state medical association. It means being a leader in your profession and making a difference in the lives and health of your patients. As Dr. Harris said: "We don't run away from problems ... physicians run towards them!" </p> <p> Won't you join me in running toward the problems, and help me affect change for the better in our profession in Washington? </p> </div>6/17/2019 12:00:00 AM1/1/0001 12:00:00 AM
2019_wsma_annual_meeting_how_to_propose_policy_serve_as_delegate2019 WSMA Annual Meeting: How to Propose Policy, Serve as DelegateLatest_NewsShared_Content/News/Membership_Memo/20190612/2019_wsma_annual_meeting_how_to_propose_policy_serve_as_delegate<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/AM_2018.10.308-645x425px.jpg" class="pull-right" /> </div> <h5> June 12, 2019 </h5> <h2>2019 WSMA Annual Meeting: How to Propose Policy, Serve as Delegate</h2> <p> If you are interested in proposing policy or serving as a delegate at the 2019 Annual Meeting of the WSMA House of Delegates, Oct. 12 and 13 at the Hilton Seattle Airport & Conference Center, be sure to take note of the following guidance and key dates. </p> <h3>Deadlines for submitting resolutions</h3> <p> Resolutions, one of the key policy drivers for the association, are considered for adoption by the House of Delegates at its annual meeting each fall. Resolutions must be sponsored by a WSMA delegate, alternate delegate or member of the board of trustees. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to develop your resolution idea and help find a sponsor. <a href="">Learn more about resolutions on the WSMA website</a> and be sure to mark your calendar for the following dates: </p> <p> <strong>Aug. 16</strong> – Deadline to submit your resolution for publication in the delegate handbook, the compilation of resolutions and other business to be considered by the House of Delegates.<br /> <strong>Aug. 30</strong> – Delegate handbook will be available from the WSMA website for download.<br /> <strong>Sept. 13</strong> – Final deadline to submit your resolution. Resolutions received after this date must have consent of two-thirds of the House at the opening session to be considered.</p> <h3>How to serve as a delegate</h3> <p>The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county society or specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2019 WSMA Annual Meeting, please contact your local county society or state specialty society. </p> </div>6/12/2019 12:00:00 AM1/1/0001 12:00:00 AM
cms_asks_whats_next_for_administrative_simplification_effortCMS Asks 'What's Next?' For Administrative Simplification EffortLatest_NewsShared_Content/News/Membership_Memo/20190612/cms_asks_whats_next_for_administrative_simplification_effort<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/" class="pull-right" /> </div> <h5> June 12, 2019 </h5> <h2>CMS Asks 'What's Next?' For Administrative Simplification Effort</h2> <p> Launched by the Centers for Medicare & Medicaid Services in 2017, the <a href="">Patients over Paperwork initiative</a> aims to streamline regulations to reduce the administrative burdens that can interfere with clinicians' primary mission of caring for patients. CMS is now seeking recommendations from physicians and other health care industry stakeholders on what "red tape" the initiative should be looking at next to help improve health care delivery. </p> <p> To solicit comments, CMS has posted a <a href="">Request for Information on the Federal Register</a>. Areas the agency is seeking feedback on include: </p> <ul> <li>Reporting and documentation requirements.</li> <li>Coding and documentation requirements for Medicare or Medicaid payment.</li> <li>Prior authorization procedures.</li> <li>Policies and requirements for rural providers, clinicians, and beneficiaries.</li> <li>Policies and requirements for dually enrolled (i.e., Medicare and Medicaid) beneficiaries.</li> <li>Beneficiary enrollment and eligibility determination.</li> <li>CMS processes for issuing regulations and policies.</li> </ul> <p> Comments must be submitted by Aug.12. <a href="">Instructions for commenting are provided in the RFI</a>. To learn more, see the <a href="">CMS press release</a>. </p> <p> The WSMA can assist members wrestling with administrative burden and other practice challenges. Contact Jeb Shepard at <a href=""></a> with your concerns. In addition to helping with immediate issues, your feedback will help inform our advocacy agenda. </p> </div>6/12/2019 12:00:00 AM1/1/0001 12:00:00 AM
washington_insurers_propose_record_low_rate_increases_for_2020_exchange_plansWashington Insurers Propose Record-Low Rate Increases for 2020 Exchange PlansLatest_NewsShared_Content/News/Membership_Memo/20190612/washington_insurers_propose_record_low_rate_increases_for_2020_exchange_plans<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/WA-Healthplanfinder-645x425px.jpg" class="pull-right" /> </div> <h5> June 12, 2019 </h5> <h2>Washington Insurers Propose Record-Low Rate Increases for 2020 Exchange Plans</h2> <p> Proposed rate increases for plans on Washington state's individual health insurance market are at record low rates for 2020, as 13 health insurers filed an average proposed rate increase of 0.96 percent - the smallest increase in the Affordable Care Act era. Two new insurers, PacificSource Health Plans and Providence Health Plan, will offer plans both on and off the Washington Health Benefit Exchange this year, helping to bring the number of counties with only one carrier down from 14 in 2019 to a proposed eight in 2020. </p> <p> After premium increases of 14 percent in 2019 and 24 percent in 2018, this year's small increase is attributed to the stability of Washington's individual market. Additionally, insurers are returning to <a href="">pre-ACA levels of profitability</a>, and the past several years of increasing premiums have resulted in record-high rebates to individual market consumers. </p> <p> The Office of the Insurance Commissioner will review the proposed rate increases and issue a recommendation, which will then be voted on by the Exchange's board in September. </p> </div>6/12/2019 12:00:00 AM1/1/0001 12:00:00 AM
washington_prescribers_can_soon_access_rx_data_across_state_linesWashington Prescribers Can Soon Access Rx Data Across State LinesLatest_NewsShared_Content/News/Membership_Memo/20190612/washington_prescribers_can_soon_access_rx_data_across_state_lines<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" /> </div> <h5> June 12, 2019 </h5> <h2>Washington Prescribers Can Soon Access Rx Data Across State Lines</h2> <p> As the result of persistent WSMA advocacy with state lawmakers and at the Department of Health, physicians in Washington will now have access to prescribing data in nearly every other state. The DOH has <a href="">announced a new data-sharing agreement</a>, under which it will now share prescription monitoring program data with nearly all states and the District of Columbia through two key hubs, <a href="">RxCheck</a> and <a href="">PMP InterConnect</a>. </p> <p> Washington was one of the first states to connect with RxCheck in 2018. Expanding to connect to the 51 jurisdictions participating in PMP InterConnect gives prescribers in Washington more options for checking prescribing data for patients and access to more information. Prescribers can connect to these hubs using secure web-access portals. </p> <p> Accessing prescription data across state lines will be particularly helpful to physicians practicing near the border with neighboring states. The WSMA will keep members updated as to when access to the cross-state data will be available. </p> </div>6/12/2019 12:00:00 AM1/1/0001 12:00:00 AM
medicare_quality_payment_program_spring_2019_updatesMedicare Quality Payment Program Spring 2019 UpdatesLatest_NewsShared_Content/News/Latest_News/2019/June/medicare_quality_payment_program_spring_2019_updates<div class="col-md-12"> <div class="col-md-5 pull-right"><img alt="" src="/images/News/Medicare_Quality_Payment_Program_logo_650x425.jpg" class="pull-right" /></div> <h5>June 6, 2019</h5> <h2>Medicare Quality Payment Program Spring 2019 Updates</h2> <p> With annual updates to Medicare's Quality Payment Program, and especially for the Merit-based Incentive Payment System (MIPS) pathway, it can be difficult for physician practices to track year-to-year changes and integrate them into their MIPS planning. The Physicians Advocacy Institute's <a href="">MACRA QPP Resource Center</a> has several resources that can help you navigate the QPP for 2019: </p> <ul> <li><a href="">2019 QPP Changes for MIPS and Advanced Alternative Payment Models (APMs)</a> – summarizes the key changes for the 2019 QPP participation year.</li> <li><a href="">Eleven Steps to Navigating the QPP</a> – helps newcomers to the program and provides information on navigating the basics of MIPS and Advanced APM pathways under the QPP framework.</li> <li><a href="" target="_blank">QPP Resource Navigation Tool</a> – houses resources and support organizations available to help navigate the QPP process and includes additional details on MIPS and APMs.</li> <li><a href="" target="_blank">MIPS Resource Navigation Tool</a> – includes resources and support organizations available to help navigate the MIPS process and provides specific information on MIPS categories, scoring, reporting, etc.</li> <li><a href="" target="_blank">Advanced APM Resource Navigation Tool</a> – provides additional information for those already participating in an Advanced APM and those interested in participating in an Advanced APM.</li> </ul> <p> PAI's <a href="">MACRA QPP Resource Center</a> contains additional resources on the QPP, MIPS, and Advanced APMs, including a <a href="">summary</a> of the key changes for the 2019 QPP performance year. </p> <h3>Other updates</h3> <p> CMS posted webinars on 2019 MIPS and Advanced APMs in the <a href="">QPP Webinar Library</a>, which include the 2019 MIPS APM Scoring Overview and the 2019 Promoting Interoperability Category Overview. CMS also posted several new resources: </p> <ul> <li><a href="">2019 Medicare Part B Claims Measure Specifications and Supporting Documentation</a> – provides descriptions of the 2019 claims measures for the MIPS quality category.</li> <li><a href="">2019 MIPS Validation Criteria</a> – provides details on the 2019 criteria used to audit and validate data submitted in each MIPS category.</li> <li><a href="">2019 Cost Measure Information Forms</a> – details the measure methodology for each of the MIPS cost category measures.</li> </ul> <p> Physicians and practices can find additional resources on MIPS and Advanced APMs in <a href="">PAI's QPP Resource Center</a> and the <a href="">CMS QPP Resource Library</a>. </p> <p> Source: <a href="">Physicians Advocacy Institute</a> </p> </div>6/6/2019 12:00:00 AM1/1/0001 12:00:00 AM
pnwu_to_host_two_day_summit_on_opioid_use_disorder_this_junePNWU to Host Two-Day Summit on Opioid Use Disorder this JuneLatest_NewsShared_Content/News/Latest_News/2019/May/pnwu_to_host_two_day_summit_on_opioid_use_disorder_this_june<div class="col-md-12"> <div class="col-md-5 pull-right"><img alt="" src="/images/Events/opioid_hydrocodone_bottle_645px.jpg" class="pull-right" /></div> <h5>May 30, 2019</h5> <h2>PNWU to Host Two-Day Summit on Opioid Use Disorder this June</h2> <p>Pacific Northwest University of Health Sciences will host a regional summit on opioid use disorder June 20-21 in collaboration with the Greater Columbia Accountable Communities of Health and Catholic Charities of Yakima. The summit, Trauma and the Opioid Crisis: Coming Together to Advance Prevention, Care, and Recovery, features five keynote speakers, including Vincent Felitti, MD, who will discuss the origins of addiction; and Steven Stanos, DO, medical director of Swedish Pain Services, who will update attendees on state and federal regulations for managing patients with chronic pain. </p> <p> Attendees can choose from 25 educational sessions in four tracks: Strategies for managing patients with opioid use disorder; patient, payment and stigma; trauma informed care; or innovative models of care. This event is open to physicians, physician assistants, nurse practitioners, and other health care professionals, and will be held on PNWU's Yakima campus. </p> <p> For more information and to register, visit <a href=""></a>. </p> </div>5/30/2019 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_may_27_2019_brand_new_brand_newsWeekly Rounds: May 27, 2019 - Brand New Brand NewsLatest_NewsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_may_27_2019_brand_new_brand_news<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>May 27, 2019</h5> <h2>Brand New Brand News</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Think about a couple of your favorite brands, and then think about how they make you feel. For me that means Starbucks (consistent, caffeinated), Apple (easy to use, good quality), and Alaska Airlines (convenient, reliable, and homegrown). </p> <p> A brand is more than just a logo. It is the set of emotions and recognition of values people have when they interact with an organization. A strong brand elicits not only thoughts and feelings from its audience, but also loyalty, passion, and motivation for action—all of which happen for me with the brands noted above. </p> <p> Many of you know that I've been with the WSMA for many years, and for the last six as CEO. So last week at our incredibly diverse WSMA Leadership Development Conference when a member told me that they had "always thought of the WSMA as an old, white, male club," I was dismayed. Are we still up against that stereotype? </p> <p> Thankfully, we've already been working on transforming the WSMA organization and brand to more appropriately represent our diverse membership of today! </p> <p> In the way of organizational change, we reorganized our association according to the express needs of our members, sharpening our focus on <a href="">advocacy</a> and <a href="">policy development</a>. We are tackling administrative burden and wellness through our <a href="">Healthy Doctors, Healthier Patients initiative</a>, and our <a href="">foundation</a> is focusing its work on bringing joy back to medicine and striving to improve physician wellness. Further, we developed <a href="">courses</a> and <a href="">networking opportunities</a> to engage and equip physician leaders, supporting them at every stage of their professional careers. </p> <p> But we didn't stop with structural change, we also looked at our brand. We started with our flagship publication, <em>WSMA Reports</em>. I hope you've noticed the huge change since the March/April issue. We wanted our flagship publication's visual aesthetic to reflect the dynamic membership of our association, to represent our members more fully within its pages, and to implement an engaging and interactive editorial approach. </p> <p> This magazine is a must-read for any physician, physician assistant, or health care leader in Washington state, and it is available for free to WSMA members. Recent issues have reported in depth on the silent suffering of burnout and how artificial intelligence can serve doctors, not replace them. Up next, with our July/August edition we'll feature in-depth reporting on how climate change is impacting the health of Washingtonians and what's being done about it. </p> <p> Through this publication and all of our communications channels, we're reporting on issues that impact Washington state physicians and their patients. We publish news that is tailored specifically for—and only available to—WSMA members. </p> <p> Beyond all that, we are in the midst of launching a new look and feel to our entire brand. While our brand is no substitute for the work we do or the interactions we have, it does help broaden our reach, strengthen our purpose, create connections across our programs, and reinforce a powerful sense of our mission and vision. Implementation of these new visuals is in progress and will be an evolution, but I'm sure you'll notice aspects of our new logo and brand in the weeks ahead. </p> <p> As always, thanks for your interest in, and support of, the WSMA. I'm all in on the WSMA brand and I hope you are too. And now, I think a Starbucks venti Americano is calling my name… </p> </div>5/27/2019 12:00:00 AM1/1/0001 12:00:00 AM
submissions_for_the_2019_william_o_robertson_patient_safety_award_due_july_17Submissions for the 2019 William O. Robertson Patient Safety Award Due July 17Latest_NewsShared_Content/News/Membership_Memo/20190522/submissions_for_the_2019_william_o_robertson_patient_safety_award_due_july_17<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Stock.image_2019.youngmpocdoctor_w_child_645x425.jpg" class="pull-right" /> </div> <h5> May 22, 2019 </h5> <h2>Submissions for the 2019 William O. Robertson Patient Safety Award Due July 17</h2> <p> The WSMA's William O. Robertson Patient Safety Award recognizes and honors patient safety initiatives being pioneered in ambulatory care settings throughout Washington state. The award was named after WSMA past president, William O. Robertson, MD, who was a champion for patient safety, risk management, and quality improvement throughout his long and distinguished career. The WSMA is now accepting submissions for the 2019 award. To have your patient safety initiative considered, <a href="">submit your information online</a> by Wednesday, July 17. The award will be presented during the 2019 WSMA Annual Meeting in Seattle, Oct. 12-13.<br /> <br /> Past winners of the William O. Robertson Patient Safety Award:<br /> <strong>2018</strong><br /> PeaceHealth Medical Group<br /> TeamHealth Northwest at CHI Franciscan<br /> <br /> <strong>2017</strong><br /> Jefferson Healthcare<br /> The Everett Clinic<br /> The Vancouver Clinic</p> </div>5/22/2019 12:00:00 AM1/1/0001 12:00:00 AM

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